IVF And Ectopic Pregnancy

One of the potential risks of fertility treatments such as In-Vitro Fertilisation (IVF) and Intrauterine Insemination (IUI) is the increased chance of ectopic pregnancy. Ectopic pregnancy occurs when a woman's egg is fertilised by her partner's sperm and the resulting embryo implants somewhere outside the woman's womb. When an embryo grows outside the womb, a potentially life-threatening situation is created for both mother and foetus. Health statistics show that approximately 1 % of all pregnancies are ectopic. Although ectopic pregnancies can occur also when a woman conceives naturally, fertility treatments such as IVF or IUI increase a fertility patient's chances of her pregnancy being ectopic.

How Ectopic Pregnancy Begins

In a normal pregnancy, a woman's ovary releases an egg which travels down her fallopian tube on the way to her womb. On its way, the egg is fertilised by a man's sperm to create an embryo. The embryo then finishes its journey as described above and implants in the womb, where, hopefully, a healthy baby will grow over the course of the next nine months. According to NHS statistics, in 95 % of ectopic pregnancies, the embryo remains in the fallopian tube - although ectopic pregnancy can occur in the cervix (the neck of the womb), the ovary and the abdominal cavity. The danger is that the affected organ will rupture and cause severe bleeding. The vast majority of ectopic pregnancies in the United Kingdom are treated effectively. Very few ectopic pregnancies actually result in the death of the mother. Generally, an embryo cannot survive an ectopic pregnancy and therefore treatment nearly always requires the removal of the embryo. Even if the ectopic pregnancy is not treated the embryo will probably not survive, although the decision not to treat the ectopic pregnancy is a highly risky one for the mother.

IVF

During IVF treatment, a woman's eggs are removed directly from her ovaries and are fertilised with her partner's sperm outside her body (in a laboratory). The resulting embryos are then inserted directly into her womb. Given that most ectopic pregnancies occur when a fertilised egg gets stuck in the fallopian tube, you might ask how IVF could possibly increase the chances of ectopic pregnancy, since IVF "bypasses" the fallopian tubes altogether. Fertility specialists believe that ectopic pregnancy may occur if, when the embryos are transferred to the womb, they are placed too high in the womb cavity. The embryos then have a greater chance of "wandering" and implanting themselves in places where they are not supposed to be, such as the fallopian tubes. Embryos could also make their way into the fallopian tubes if they are injected into the womb with too much force. In the past, doctors would block the fallopian tubes during IVF treatment to try and prevent ectopic pregnancy from occurring. This method is no longer used.

IUI

IUI treatment involves inserting sperm directly into the womb cavity to help the sperm reach and fertilize a woman\'s egg. This treatment may also increase the risk of a pregnancy developing in the fallopian tubes or elsewhere if the sperm is injected with too much force or is placed too high in the womb cavity.

What Are The Chances?

Between 2 and 5 % of IVF treatments result in ectopic pregnancy. If you are undergoing either IVF or IUI treatment and you do get pregnant, keep an eye out for symptoms of ectopic pregnancy. If you believe you are experiencing any of these symptoms, get medical help immediately.

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HelgaJust wanted to comment on the info above as I feel some of the wording is a bit misleading. 'Generally an embryo cannot survive an ectopic pregnancy...' Yes, there have been documented cases of babies being born when they have grown outside the womb but as far as I'm aware they have always been the very rare ectopics which have implanted in the abdomen. An ectopic pregnancy in the Fallopian tube, which is the most common type of ectopic, cannot survive because the tube physically can't expand with a growing embryo without rupturing and cannot provide the nutrients the baby needs. Therefore, the word 'generally' is a bit misleading as it is so extremely rare for a healthy baby to be born from an ectopic.
'Even if the ectopic pregnancy is not treated the embryo will probably not survive, although the decision not to treat the ectopic pregnancy is a highly risky one for the mother' is also misleading; 90% of ectopic pregnancies are never a viable embryo in any case, most are sadly just a sac, and an embryo cannot grow successfully outside the womb, except in those very very rare cases when they grow in the abdomen which can prove large enough to expand with a growing baby and I can't stress enough how rare that is. Medical science has not yet discovered a way to move an ectopic pregnancy to the right place and, although the 'watch and wait' approach is used to treat an ectopic in the UK, that is only done when the doctors consider the pregnancy to be dissolving on its own and at a very low risk of continuing to grow and rupture. As far as I'm aware in the UK at least, you wouldn't be given the choice to decline treatment to see if the baby survives because the risks are too great and the outcome would not be a healthy baby.
I did read of one case recently in the UK where a lady had an abdominal ectopic which wasn't discovered until about 20 weeks. She pushed to continue with the pregnancy and delivered very early via laparotomy and the baby survived. This is very rare. Most ectopics are discovered within the first 10 weeks and require treatment to prevent rupture of the tubes.
My reason for posting is that I suffered an ectopic after IVF and I would hate to think that someone in the same position thought they may have a choice to not have treatment in the hope the baby might survive. An ectopic pregnancy is life-threatening to the mother if left untreated and, although it is the most sickening feeling ever to know that you have no choice but to lose the baby you have longed for, either via injection or surgery, there is no other option. Although guilt is a common emotion felt after an ectopic you must realise that you didn't have a choice so it wasn't your fault that the pregnancy had to end. Good luck to anyone going through this-it's hell but you will get through it.